The nurse is caring for a 70-kg patient in hypovolemic shock
Upon initial assessment, the nurse notes a blood pressure of 90/50 mm Hg, heart rate 125 beats/min, respirations 32 breaths/min, central venous pressure (CVP/RAP) of 3 mm Hg, and urine output of 5 mL during the past hour. Following physician rounds, the nurse reviews the orders and questions which order? a. Administer acetaminophen (Tylenol) 650-mg suppository prn every 6 hours for pain.
b. Titrate dopamine (Intropin) intravenously for blood pressure < 90 mm Hg systolic.
c. Complete neurological assessment every 4 hours for the next 24 hours.
d. Administer furosemide (Lasix) 20 mg IV every 4 hours for a CVP > 20 mm Hg.
B
Vasoconstrictive agents should not be administered for hypotension in the presence of circulation fluid volume deficit. The nurse should question the use of the dopamine (Intropin) infusion. All other listed orders are appropriate and have potential for use in the treatment of a hypovolemic shock.
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